WQCS00144_System Permit Renewal Reminder_20220321

DocuSign Envelope ID:8979C317-15BE-4DFD-9BB9-4A083E80128B
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ROY COOPER i I f -4.r.,."")
Governor '' .
ELIZABETH S.BISER
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Secretary
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S.DANIEL SMITH NORTH CAROLINA
Director Environmental Quality
Kevin Baughn,Town Manager
Town of Madison
120 N Market St
Madison, NC 27025
Subject: System-Wide Collection System Permit Renewal Reminder
Madison Collection System
Permit No.WQCS00144
To Whom It May Concern,
This letter is a reminder that the above referenced permit is set to expire on 12/31/2022. Per 15A NCAC
02T.0109,a renewal application should be received 180 days prior to expiration,which in this case is no later
than 7/4/2022. If this date has passed, please respond immediately to avoid a compliance violation. The
application for the renewal can be downloaded using the following steps:
• Go to: https://deq.nc.gov/about/divisions/water-resources/water-resources-permits/wastewater-
branch/collection-systems/system-wide-collection-system-permitting
• Click on Wastewater Collection System Application—New/Renewal(Form CSA 04/16)
The original application,signed by an authorized signing official,with requisite supporting documentation as
well as one digital copy of the complete application packet must be submitted to the following address:
Via USPS: Via Other Couriers:
DWR-Municipal Permitting Unit DWR-Municipal Permitting Unit
Attn:WQCS Renewals Attn:WQCS Renewals
1617 Mail Service Center 512 N.Salisbury St.,9th Floor
Raleigh, NC 27699-1617 Raleigh,NC 27604-1170
If you have any questions, please contact Michael Montebello at [e-mail].
Sincerely, ,
AA,,• D,ocuSipned by:
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M ,140.01(11.6
Mich64 31431644E
ael Montebello,Supervisor
Municipal Permitting Unit
Division of Water Resources
cc: Winston-Salem Regional Office,Water Quality Regional Operations Section
Municipal Permitting Unit Files-WQCS00144
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rth NorthCarolina SalisburyDepartment Street 1 of1617Env Mail
r n Serviceental Center I Raleigh.ision Northofater Carolinaso 2769res 9-1617
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